DESCRIPTION OF THE OVERALL PROGRAM: (Taken from the application) This proposal from the Children's Hospital Medical Center in Cincinnati has the goal of impacting a clinical practice as it is applied to the most common rheumatic diseases of childhood. This proposal also represents in part the competing renewal for the Centers existing P60 MAMDC and is complimentary to the P30 Cincinnati Rheumatic Diseases Core Center submitted earlier this year. It is estimated that 140,000-200,000 children within the United States have rheumatic disease, many, but not all, of which are autoimmune. The major diseases are juvenile rheumatoid arthritis, systemic lupus erythematosus, scleroderma and juvenile dermatomyositis. Of increasing impact are illnesses with regional and generalized musculoskeletal pain syndromes of which fibromyalgia is particularly common and appears to be increasing in frequency and can present a major management problem. The five components of the Center are: A methods core interacting with all projects; A trial of etanercept in juvenile dermatomyositis; A study of psychological status in juvenile onset fibromyalgia; An imaging study using quantitative T2 mapping JRA; Methotrexate pharmacogenomics in JRA. In addition, there is an administrative unit which will exercise operational control and administrative oversight of all the projects through an executive committee, two Advisory Boards and a Community-Based Board of Directors. The short- and long-term goals are to improve the health of children with these conditions and to better ensure a smooth transition from childhood and adolescence through to young adulthood for the child with a chronic rheumatic disease.